Scots GPs may miss flu target

GPs are warning the Shipman Inquiry's recommendations could turn general practice into a 'police state' and further damage morale.

They accuse the inquiry of confusing the need to stop a serial killer with addressing underperformance and say GPs will have to work in a 'regulatory straitjacket' if ministers accept the findings.

Dame Janet Smith's recommendations included giving PCTs the power to fine GPs for 'deficient clinical practice', monitoring of patient death rates for each GP, and a national database of GPs containing any relevant clinical governance information.

The Government has said it will reply to the report early next year. But most GPs said the inquiry had gone too far.

Dr Ken Megson, secretary of Gateshead and South Tyneside LMC and a GP in Gateshead, said fining GPs was 'one-sided' and would lead more doctors to quit.

He said: 'If I am fined for complaints I want patients to be fined for misuse of services. Patients go on about their rights but not their responsibilities. No wonder we are all going to retire early.'

Dr John Grenville, a GP in Derby who gave evidence to the inquiry, said mortality rates varied so much between doctors it would to be difficult to detect anything amiss, while 'outlier' practices would always be viewed with suspicion.

Dr Nick Plant, chair of the professional executive committee at Dudley South PCT, was concerned trusts would compile files of unsubstantiated concerns about GPs.

NHS Alliance chair Dr Mike Dixon said the proposals could drive GPs into retirement by increasing red tape. 'It's important we don't make the NHS into a police state.'

Dr Jeff Moysey, a GP who practised in the same premises as Shipman for nine years, said the report suggested an agenda for PCOs to end GPs' independent contractor status and make them NHS employees.

Dame Janet said GPs' status made it difficult for PCOs to 'manage' them.

'There is huge potential for great harm to morale. It has the potential to be incredible intrusive,' Dr Moysey said.